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La Rivista Italiana della Medicina di Laboratorio 2020 Settembre;16(3):148-65

DOI: 10.23736/S1825-859X.20.00062-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: Italian

Iron deficiency biomakers: new pathophysiological acquisitions and interpretative needs

Fabrizio PAPA ¹ ✉, Valentino MICONI ², Bruno BIASIOLI ², Anna M. CENCI ², Maria GOLATO ²

¹ U.O.C. di Patologia Clinica, Ospedale San Giovanni Calibita Fatebenefratelli Isola Tiberina, Roma, Italia; ² SIPMeL, Castelfranco Veneto, Treviso, Italia

Iron is the fourth most abundant element on the earth’s crust. It constitutes an essential component of almost all biological systems, and it is vital for humans, playing a crucial role in oxygen transport, oxidative metabolism, cell proliferation and in many catalytic reactions. Its metabolism is one of the most complex biological processes in the human body. It involves many organs and tissues, and their interaction is essential to maintain homeostasis. Understanding these mechanisms has improved thanks to scientific research, leading to the discovery and characterization of proteins that regulate iron physiology while playing an important role in the pathogenesis of martial deficiency diseases. This deficiency represents a global and social health problem, being one of the main non-fatal disease conditions worldwide. Although it is frequently managed in daily clinical practice, iron deficiency prevalence is often overlooked or neglected, especially in patients with inflammatory conditions. This is partly due to heterogeneity of definition provided by clinical guidelines, and partly to the difficult interpretation of available tests. The purpose of this review was to highlight the best evidence for the correct use of iron deficiency biomarkers available, while pointing out the correct management of their clinical thresholds and/or decision-making levels.

KEY WORDS: Anemia; Iron deficiency; Diagnosis; Interpretative report; Analytical methods